Provider Demographics
NPI:1356783302
Name:CONNER, NATASHIA (MS, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:NATASHIA
Middle Name:
Last Name:CONNER
Suffix:
Gender:F
Credentials:MS, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6504 SIMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-1804
Mailing Address - Country:US
Mailing Address - Phone:513-578-2951
Mailing Address - Fax:
Practice Address - Street 1:6504 SIMPSON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-4713
Practice Address - Country:US
Practice Address - Phone:513-578-2951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2017-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X, 174H00000X, 332B00000X, 374J00000X
OHL-56274174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty